1994 Volume 8 Issue 6 Pages 697-704
Primary resection for lung cancer was performed in 610 patients. Extensive surgery was performed in 146 (23.9%). The operative mortality was 6.2%. In this group the 5-year survival rate was 24.3%. Survival was better in patients with T3 disease (32.2%) than in patients with T4 disease (13.5%) (p <0.05). This was also true in the NO group (31.4%) compared with the N2 group (7 %) (p<0.05). Patients who underwent curative operations also had better survival (32.9%) compared with those who underwent palliative procedures (16.9%) (p <0.01). Better survival was noted in patients who underwent single organ resection (29.3%) compared with those who underwent multiple organ resection (12.7%) (p< 0.05). The 5-year survival of patients who underwent partial resection of the chest wall (n= 100), pericardium (n=37), trachea (n=12), or left atrium (n=16) was 23.6%, 19.7%, 41.3%, and 17.6%, respectively. None of the patients who underwent partial resection of the thoracic vertebrae (n=6), brachiocephalic or subclavian veins (n=6), esophagus (n=4), aorta (n=3), intra-pericardial pulmonary artery (n=3), subclavian artery (n=3), or superior vena cava (n=2) survived longer than 3 years. Twenty-one patients survived more than 5 years. The pathologic staging was T3NOMO (n=10), T3N1M0 (n=4), T3N2M0 (n=1), T3N3M0 (n=1), T4NOMO (n=2), T4N1M0 (n=2), or T4N2M0 (n=1). Histologic examination revealed squamous cell carcinoma (n=12) or adenocarcinoma (n=7) in the majority of cases. Long term survival can be expected in patients with squamous cell carcinoma even with N2 disease. In patients with adenocarcinoma, the prognosis associated with N2 disease was poor. However, six patients with NO or Ni adenocarcinoma survived 5 years.
